Laserfiche WebLink
SITE ADDRE9S <br />� a- � �l <br />LEf3A LOT NO. <br />� <br />�-ERMIT APPLICATIVN <br />CITY OF EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT WA 98201 <br />425-257-8810 - FAX 425-25?-8857 <br />_ �� 3��- - Do � <br />PARCEL TAR I.D.11 PERMit M <br />• � . � C o3 .n3 �__ <br />e�ocK rpacr <br />OWNF.R Ai%OHEfS � ZIP PMONE <br />IClM 1C� � uJ � ��_ � � � c l�i-� <br />e cc� r IGc� j„c�F T. .,c.J r�.re,�4 9�1��H 3�S ���(o'i <br />TENAM NAME I CONTACTNAME ' VNOHE <br />CR {�rtRACTOR AODRE38 Z'P CONTR. UCEN9E • <br />1^110� Lvr.Si. �+,•�4 �r5�`1��Fo;r 10334 li.'�a� AvL S�. A\ol.r.�lv�l0(31..) <br />PHONE <br />.5�� �4�� 3J i� <br />PROPOSEO U9E OF BUILOINU <br />PERMIT <br />TVPE <br />CONTRACT PqICE OF <br />� <br />� <br />� <br />� <br />y�^ur�c�o e <br />�tH.�l�_ <br />Bullding MecheNcal ���iii Aeenlon HEAT SOUFCE <br />Combinellon R Plumbing WORK � Alteretlon li Electdc <br />Uemolltlon d Sign TVPE New Oee <br />SpdflklBf (M of heade) Repelr/Melnt. B pthet <br />CITY OF EVERETT LOCAL SALEB TAX CODE 19 7106 <br />WORK DIE�BCRIPTON I <br />it�-YA.(.l- �"��.������' C6I.�N�tnY CI"� L+(i��5��1� �J���` (i-t`(.ilvrlC'� C�n' �, <br />,n� � <br />PLUMHING <br />N0. � TYPE OF FI%TUqE OH REM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KIT(:HEN SINK 8 DISPOSAL <br />DISHJYASHER <br />UIUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FCUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PRF.`.'EN7ER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />NO. � TYPE OF FlXTURE OR REM <br />WC - A/HANDLINO UNITS <br />FOHC�D AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />_ CLOTHES �RVER <br />_ RANOEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />i OAS FIREPLACE <br />OAS RANaE <br />OAS PIPINO <br />_ EXHAUST FAN <br />_,_ OTHER _ <br />I HEFiEDV CERITIFV THAT I HAVE READ AND E%AMINED THIS APPLICATION AND KqOV! TNE SAME TO BL TRUE AND COFHECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES OOVERNING THIS TVPE OF WORK W��L BE C041PLIED WITH WHETHER SPECtFIED HEREIN OR <br />NOT. THE Gi7ANTINO OF A PEFRIIT DOES NOT PRESUME TO �IVE AUTHOFIT' TO VIOLATE OR CANCEL TME PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW FE6ULATINO CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUiHOFIZED BY THE <br />OWNEP OF IS PRpPERTY TO PERFORM THE WORK FOR'NHICH APFLICATIOi! IS 1.'.4DE AND I COMPI.V WITH THE STATE <br />CON7RA S LAW 18.27 � W AND 296200 WAC. <br />!�- . i' � �%G� C � <br />ignature o wnar ontrector/ uthorize gant ate � <br />3 <br />